Patient data mining for automated compliance

ABSTRACT

A technique is provided for automatically generating performance measurement information. At least some of the obtained performance measurement information may be derived from unstructured data sources, such as free text physician notes, medical images, and waveforms. The performance measurement may be sent to a health care accreditation organization. The health care accreditation organization can use the performance measurement to evaluate a health care provider for its quality of patient care. Alternatively, performance measurement information can be provided directly to consumers.

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. ProvisionalApplication Serial No. 60/335,542, filed on Nov. 2, 2001, which isincorporated by reference herein in its entirety.

FIELD OF THE INVENTION

[0002] The present invention relates to medical information processingsystems, and, more particularly to a computerized system and method forproviding automated performance measurement information for health careorganizations.

BACKGROUND OF THE INVENTION

[0003] Health care organizations need to generate various types ofperformance measurement information to determine how well they areprogressing over time. Health care organizations typically use thisinformation to determine areas of excellence within their organizationsas well as those areas that need improvement. Performance measurementinformation provides an objective basis for planning and makingbudgeting decisions. In addition, performance measurement informationcan be used to demonstrate accountability to the public and to back upclaims of quality. Frequently, performance measurement information isprovided to accreditation organizations for compliance purposes.

[0004] The Joint Commission on Accreditation of Healthcare Organizations(JCAHO), an organization that accredits more than 4,700 hospitalsnationwide, requires that participating hospitals provide certain typesof performance measurement information. For example, JCAHO requires thatparticipating hospitals provide information regarding patients treatedfor acute myocardial infarction (AMI). As one example of the type ofinformation that must be provided, hospitals are required to indicatewhether an AMI patient without aspirin contraindication received aspirinwithin 24 hours before or after hospital arrival. Because it is believedthat early treatment with aspirin markedly reduces mortality for AMI,JCAHO requires hospitals to report this information.

[0005] Currently, performance measurement information must be collectedfrom a myriad of structured and unstructured data sources to comply withaccreditation requests. For example, it may be necessary to accessnumerous different databases, each with its own peculiar format. Worse,physician notes may have to be consulted. These notes usually arenothing more than free text dictations, and it may be very difficult tosift through the notes to gather the necessary information. As a result,the effort taken to collect this information is usually time consuming,expensive, and error prone. Furthermore, usually only a small sample ofpatient data can be supplied.

[0006] Given the importance of collecting accurate performancemeasurement information, it would be desirable and highly advantageousto provide new techniques for automatically generating performancemeasurement information for health care organizations.

SUMMARY OF THE INVENTION

[0007] The present invention provides a technique for automaticallygenerating performance measurement information for health careorganizations.

[0008] In various embodiments of the present invention, a method isprovided that includes formulating a query based on a specifiedperformance measurement category. This query is then executed to obtainperformance measurement information. At least some of the obtainedperformance measurement information may be derived from unstructureddata sources, such as free text physician notes.

[0009] The performance measurement information can be outputted. Theperformance measurement information may be sent to a health careaccreditation organization. An example of a health care accreditationorganization is the Joint Commission on Accreditation of Health CareOrganizations (JCAHO).

[0010] Performance measurement information can include patientinformation from a health care provider being evaluated. For example, ahealth care accreditation organization may evaluate a hospital for itsquality of care in treating heart attack patients. This patientinformation may include clinical information, financial information, anddemographic information.

[0011] The obtained performance measurement information may be sampledfrom a patient population. Alternatively, it may be obtained for anentire patient population.

[0012] Performance measurement information may be generated by a healthcare provider, third party service provider, or an accreditationorganization. The performance measurement information may be madeavailable using a network, such as, for example, the Internet.

[0013] In various embodiments, an evaluation score of a health careprovider may be calculated using the obtained performance measurementinformation. This evaluation score may be outputted for evaluatinghealth care providers. Health care consumers may have the opportunity toview or download evaluation information via the Internet. Health careproviders may be ranked according to the evaluation scores. Suchrankings may be done for various performance measurement categories.

[0014] These and other aspects, features and advantages of the presentinvention will become apparent from the following detailed descriptionof preferred embodiments, which is to be read in connection with theaccompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[0015]FIG. 1 is a block diagram of a computer processing system to whichthe present invention may be applied according to an embodiment of thepresent invention;

[0016]FIG. 2 shows an exemplary automated performance measurementinformation system in accordance with an embodiment of the presentinvention;

[0017]FIG. 3 shows an exemplary query for selecting performancemeasurement information; and

[0018]FIG. 4 shows a flow diagram outlining an exemplary technique forautomatically generating performance measurement information.

DESCRIPTION OF PREFERRED EMBODIMENTS

[0019] To facilitate a clear understanding of the present invention,illustrative examples are provided herein which describe certain aspectsof the invention. However, it is to be appreciated that theseillustrations are not meant to limit the scope of the invention, and areprovided herein to illustrate certain concepts associated with theinvention.

[0020] It is also to be understood that the present invention may beimplemented in various forms of hardware, software, firmware, specialpurpose processors, or a combination thereof. Preferably, the presentinvention is implemented in software as a program tangibly embodied on aprogram storage device. The program may be uploaded to, and executed by,a machine comprising any suitable architecture. Preferably, the machineis implemented on a computer platform having hardware such as one ormore central processing units (CPU), a random access memory (RAM), andinput/output (I/O) interface(s). The computer platform also includes anoperating system and microinstruction code. The various processes andfunctions described herein may either be part of the microinstructioncode or part of the program (or combination thereof) which is executedvia the operating system. In addition, various other peripheral devicesmay be connected to the computer platform such as an additional datastorage device and a printing device.

[0021] It is to be understood that, because some of the constituentsystem components and method steps depicted in the accompanying figuresare preferably implemented in software, the actual connections betweenthe system components (or the process steps) may differ depending uponthe manner in which the present invention is programmed.

[0022]FIG. 1 is a block diagram of a computer processing system 100 towhich the present invention may be applied according to an embodiment ofthe present invention. The system 100 includes at least one processor(hereinafter processor) 102 operatively coupled to other components viaa system bus 104. A read-only memory (ROM) 106, a random access memory(RAM) 108, an I/O interface 110, a network interface 112, and externalstorage 114 are operatively coupled to the system bus 104. Variousperipheral devices such as, for example, a display device, a diskstorage device(e.g., a magnetic or optical disk storage device), akeyboard, and a mouse, may be operatively coupled to the system bus 104by the I/O interface 110 or the network interface 112.

[0023] The computer system 100 may be a standalone system or be linkedto a network via the network interface 112. The network interface 112may be a hard-wired interface. However, in various exemplaryembodiments, the network interface 112 can include any device suitableto transmit information to and from another device, such as a universalasynchronous receiver/transmitter (UART), a parallel digital interface,a software interface or any combination of known or later developedsoftware and hardware. The network interface may be linked to varioustypes of networks, including a local area network (LAN), a wide areanetwork (WAN), an intranet, a virtual private network (VPN), and theInternet.

[0024] The external storage 114 may be implemented using a databasemanagement system (DBMS) managed by the processor 102 and residing on amemory such as a hard disk. However, it should be appreciated that theexternal storage 114 may be implemented on one or more additionalcomputer systems. For example, the external storage 114 may include adata warehouse system residing on a separate computer system.

[0025] Those skilled in the art will appreciate that other alternativecomputing environments may be used without departing from the spirit andscope of the present invention.

[0026] Referring to FIG. 2, an automated performance measurement system216 is illustrated. The automated performance measurement system 216 isshown connected to a data repository which contains structured patientinformation collected from one or more health care organization. Thisdata repository is called a structured clinical patient record (CPR)214. The CPR 214 is shown connected to a data miner 212 which mineshigh-quality structured clinical information from unstructured patientinformation 210.

[0027] Preferably, the structured CPR 214 is populated with patientinformation using data mining techniques described in “Patient DataMining,” by Rao et al., Attorney Docket No. 2001P20906US01, copendingU.S. patent application Ser. No. ______, filed herewith, which isincorporated by reference herein in its entirety.

[0028] That disclosure teaches a data mining framework for mininghigh-quality structured clinical information. The data mining frameworkincludes a data miner that mines medical information from a computerizedpatient record based on domain-specific knowledge contained in aknowledge base. The data miner includes components for extractinginformation from the computerized patient record, combining allavailable evidence in a principled fashion over time, and drawinginferences from this combination process. The mined medical informationis stored in a structured computerized patient record.

[0029] Referring again to FIG. 2, the automated performance measurementsystem 216 can be configured to generate performance measurementinformation for one or more performance measurement category. Once aperformance measurement category is selected, a query can be formulatedbased on the selected performance measurement category.

[0030] The query is then executed to obtain performance measurementinformation. At least some of the obtained performance measurementinformation may be derived from unstructured data sources, such as, forexample, free text, medical images and waveforms.

[0031] An exemplary query is shown in FIG. 3. In accordance with JCAHOaccreditation requirements, hospitals must indicate whether an acutemyocardial infarction (AMI) patient without aspirin contraindicationreceived aspirin within 24 hours before or after hospital arrival. Thequery shows that all AMI patients are selected except those excludedunder JCAHO guidelines. JCAHO excludes patients who are less than 18years of age, transferred to another acute care hospital on day ofarrival, received in transfer from another hospital, discharged on dayof arrival, expired on day of arrival, left against medical advice onday of arrival, or have aspirin contraindications.

[0032] It should be appreciated that the query shown in FIG. 3 is shownfor illustrative purposes only. Further, it is to be appreciated thatthe actual performance measurement categories used to implement thepresent invention can relate to any type of performance measurement,including those related to any aspect of health care quality, safety, orcompliance with standards.

[0033] As mentioned previously, the performance measurement informationcan be sent to a health care accreditation organization such as JCAHO.The obtained performance measurement information may be sampled orobtained for an entire patient population.

[0034] Performance measurement information may be generated by a healthcare provider, third party service provider, or an accreditationorganization. The performance measurement information may be madeavailable using any suitable network.

[0035] In order to empower health care consumers, an evaluation score ofa health care provider may be determined using the obtained performancemeasurement information. Consumers may view or download this evaluationinformation via the Internet, for example. Health care providers may beranked according to the evaluation scores. Such rankings may be done forvarious performance measurement categories. For example, hospitals in aparticular geographic area may be ranked according to quality of care intreating prostate cancer. There may be another list that ranks hospitalsnationwide for quality of care in treating infectious diseases, etc.

[0036] Referring to FIG. 4, a flow diagram outlining an exemplarytechnique for automatically generating performance measurementinformation is illustrated. Beginning at step 401, a performancemeasurement category is selected. This may involve selecting from amongseveral performance measurement categories that are presented to a user.(Of course, this step may be skipped if there is only one performancemeasurement category).

[0037] In step 402, a query is formulated based on the selectedperformance measurement category. (This may involve formulating a querysuch as the one shown in FIG. 3). The query may be formulated to selectall patients for the performance measurement category or only a sampleof them. The particular sample size may be input as a parameter value.

[0038] In step 402, the query is executed to obtain performancemeasurement information. At least some of the obtained performancemeasurement information may have been derived from unstructuredinformation. Preferably, this information resides in a structured datarepository that is populated using mined unstructured patientinformation, as described in “Patient Data Mining,” by Rao et al.,Attorney Docket No. 2001P20906US01, copending U.S. patent applicationSer. No. ______.

[0039] In step 404, a compliance report is formatted. While this stepinvolves creating a report, it should be appreciated that there are manyother ways to output performance measurement information. For instance,the performance measurement information may be output to a magnetic oroptical disc, electronically transmitted, or displayed upon a screen.

[0040] In step 405, a determination is made as to whether any morereports are to be generated. If there are, then control returns back tostep 401; otherwise, control continues to step 406 where the operationstops.

[0041] As shown in FIGS. 1-4, this invention is preferably implementedusing a general purpose computer system. However the systems and methodsof this invention can be implemented using any combination of one ormore programmed general purpose computers, programmed microprocessors ormicro-controllers and peripheral integrated circuit elements, ASIC orother integrated circuits, digital signal processors, hardwiredelectronic or logic circuits such as discrete element circuits,programmable logic devices such as a PLD, PLA, FPGA or PAL, or the like.In general, any device capable of implementing a finite state machinethat is in turn capable of implementing the flowchart shown in FIG. 3can be used to implement this system.

[0042] Although illustrative embodiments of the present invention havebeen described herein with reference to the accompanying drawings, it isto be understood that the invention is not limited to those preciseembodiments, and that various other changes and modifications may beaffected therein by one skilled in the art without departing from thescope or spirit of the invention.

What is claimed is:
 1. A method for automatically generating performancemeasurement information for health care organizations, comprising thesteps of: formulating a query based on a specified performancemeasurement category; and executing the query to obtain performancemeasurement information, at least some of the obtained performancemeasurement information obtained from mined data sources.
 2. The methodof claim 1, further including the step of outputting the obtainedperformance measurement information.
 3. The method of claim 1, whereinthe obtained performance measurement information includes patientinformation for a health care provider being evaluated.
 4. The method ofclaim 3, wherein the patient information includes at least one ofclinical information, financial information, and demographicinformation.
 5. The method of claim 1, wherein the performancemeasurement categories includes one or more of acute myocardialinfarction, heart failure, pneumonia, and pregnancy.
 6. The method ofclaim 2, wherein the outputted performance measurement information issent to a health care accreditation organization.
 7. The method of claim2, wherein the outputted performance measurement information includescompliance metrics determined by regulatory organizations.
 8. The methodof claim 6, wherein the health care accreditation organization accreditsat least one of hospitals, ambulatory care facilities, assisted livingfacilities, behavioral health care facilities, long-term carefacilities, office-based surgery facilities, home care providers, andlaboratories.
 9. The method of claim 1, wherein the obtained performancemeasurement information relates to the quality of care for the specifiedperformance measurement category.
 10. The method of claim 1, wherein themined data sources include mined unstructured data sources.
 11. Themethod of claim 1, wherein the obtained performance measurementinformation is sampled from a patient population.
 12. The method ofclaim 1, wherein the obtained patient performance measurementinformation is obtained for an entire patient population for thespecified performance measurement category.
 13. The method of claim 2,wherein the outputted performance measurement information is sent to ahealth care accreditation organization.
 14. The method of claim 1,further including the steps of: calculating an evaluation score of ahealth care provider using the obtained performance measurementinformation; and outputting the evaluation score for evaluating healthcare providers.
 15. The method of claim 14, wherein the outputtedevaluation scores are made available to consumers via the Internet. 16.The method of claim 15, wherein health care providers are rankedaccording to the evaluation scores.
 17. The method of claim 16, whereinrankings are done for performance measurement categories.
 18. The methodof claim 1, wherein the performance measurement information is generatedby a third party service provider.
 19. The method of claim 2, whereinthe outputted performance measurement information is output via theInternet.
 20. The method of claim 1, wherein the performance measurementinformation is generated at a health care accreditation organization.21. The method of claim 1, wherein the performance measurementinformation is probabilistic.
 22. A program storage device readable by amachine, tangibly embodying a program of instructions executable on themachine to perform method steps for automatically generating performancemeasurement information for health care organizations, the method stepscomprising: formulating a query based on a specified performancemeasurement category; and executing the query to obtain performancemeasurement information, at least some of the obtained performancemeasurement information obtained from mined unstructured data sources.